Exam 2- Respiratory

Question 1

What would be the best way to stop continuous sneezing in a dog?

Answer 1

Intranasal application of a topical anesthetic

Question 2

Why do bronchodilators sometimes decrease coughing?

Answer 2

Primary stimulus for coughing due to bronchoconstriction

-Bronchodilators administered to help decrease constriction

Question 3

What are the limitations for using dextromethorphan or antihistamines as cough suppressants in dogs?

Answer 3

a. Short half-life

b. Limited bioavailability- dextromethorphan

Question 4

Which opioid has the least antitussive effect?

Answer 4

Oxymorphone

Question 5

How much evidence supports the use of Hydrocodone as an antitussive?

Answer 5

Gold standard narcotic antitussive, direct suppression of cough reflex in the medullary cough center

Question 6

How much evidence supports the use of Butorphanol as an antitussive?

Answer 6

Excellent antitussive, alternative to Hydrocodone

Question 7

How much evidence supports use of Maropitant as an antitussive?

Answer 7

Neurokinin receptor antagonist, no anti-inflammatory effects but will decrease cough

Question 8

How much evidence supports the use of Diphenoxylate as an antitussive?

Answer 8

Crosses the BBB to target opioid receptors in the medullary cough center; used in chronic bronchitis/tracheal collapse treatment

Question 9

What benefits does furosemide have in managing pulmonary edema in addition to its diuretic effect (that decreases preload)?

Answer 9

a. Diuretic action

b. Produces local vasodilatory prostaglandin in the lung

Question 10

What benefit do opioids have in managing dyspnea besides sedation?

Answer 10

Desensitizes CO2 receptors

Question 11

What drug is best suited to decrease pulmonary hypertension w/o having prominent effects on systemic BP?

Answer 11

Sildenafil

Question 12

What are the benefits of using a glucocorticoid inhaler versus systemic administration? Name one example of an inhaled steroid.

Answer 12

a. Glucocorticoid inhalers produce less systemic side effects, act locally in the lungs, & have higher first pass effects compared to systemic administration of glucocorticoids
b. Examples:
i. Fluticasone
ii. Beclomethasone
iii. Ciclesonide

Question 13

Feline asthma & equine COPD are primarily problems involving inhalation or exhalation?

Answer 13

Exhalation problems

Question 14

What is a heave line in a horse & why does it occur?

Answer 14

Heave line- abdominal muscles in horse w/ heaves will enlarge due to chronic overuse

Question 15

What are the most common side-effects of beta2 agonist bronchodilators?

Answer 15

Tachycardia
Lowering serum potassium
Airway inflammation

Question 16

Explain how to perform an atropine-challenge test in equine COPD.

Answer 16

Give dose IV
Diminished heave line→ horse may be responding positively to bronchodilators
Does not provide definitive diagnosis

Question 17

Major beta2 agonist bronchodilators used in horses- ROA & side-effects

Answer 17

Albuterol- inhaled, airway inflammation

Clenbuterol- oral, alters muscle function

Question 18

Major beta2 agonist bronchodilators used in humans- ROA & side-effects

Answer 18

Levalbuterol- inhaled, tremors, headaches, dizziness

Terbutaline- parenteral, tremors, dizziness

Question 19

Why are glucocorticoids often given to animals receiving chronic beta-2 bronchodilators?

Answer 19

Sensitizes beta receptors to the actions of agonists

Question 20

What major benefit does Theophylline provide in respiratory disease beyond bronchodilation?

Answer 20

Increases the strength of resp. muscles, especially the diaphragm

Question 21

What are three methylxanthine compounds?

Answer 21

Caffeine
Theobromine
Theophylline

Question 22

How does Aminophylline differ from Theophylline?

Answer 22

Aminophylline- water-soluble salt of Theophylline; IV or oral
Theophylline- oral only

Question 23

What effect does oxygen have on the pulmonary vasculature?

Answer 23

Vasodilation

Question 24

What toxicity signs are most seen with a Theophylline overdose?

Answer 24

Seizures, cardiac arrhythmias, vomiting

Question 25

What are the best methods for promoting expectoration?

Answer 25

Guaifenesin, saline expectorants, volatile oils

Question 26

Name the drugs used as expectorants, their proposed MOA, & their effectiveness

Answer 26

a. Expectorants- stimulation of the tubulo-acinar glands
i. Avoid use of cholinergic drugs, creates undesirable side-effects
b. Guaifenesin
i. Dog at 50mg/kg po= no effect
ii. Rat 250mg/kg po= 2x increase
iii. Cat 1000mg/kg po required for consistent change
c. Saline expectorants
i. Ammonium chloride
ii. Potassium or calcium chloride
iii. Sodium or potassium citrate
iv. Ammonium carbonate
d. Volatile oils
i. Eucalyptus
ii. Menthol

Question 27

Explain the benefit to an animal with respiratory foam due to pulmonary edema of bubbling oxygen through a 20% ethanol solution.

Answer 27

a. Ethanol acts as a surfactant that breaks up the bubbles/dries out the foam

Question 28

What is the only analeptic drug used in veterinary medicine and what toxicity is associated with its overdose?

Answer 28

a. Doxapram
i. Increases respiration during apnea or depressed respiration
ii. Very small therapeutic index→ give repeat doses cautiously if at all
iii. CNS overstimulation – seizures

Question 29

What are the primary respiratory side effects associated with Antihistamine use in any species?

Answer 29

Drying out of the resp. tract

Question 30

What are the primary resp. side effects associated with Bromide use in cats?

Answer 30

Pneumonitis

Question 31

What are the primary resp. side effects associated with Cisplatin use in cats?

Answer 31

Pulmonary edema

Volume overload, especially in cardiac failure or renal failure patients

Question 32

What are the primary resp. side effects associated with Nebulized Acetylcysteine in any species?

Answer 32

Bronchospasm, type I hypersensitivity